Introduction
Marketplace plans are a type of health insurance that is available to people who aren't covered by their employer, Medicare or Medicaid. Marketplace plans offer coverage for doctor's visits, hospital stays and prescription drugs. They also include free preventive services like vaccines and cancer screenings. Marketplace plans can only be purchased through the Health Insurance Marketplace. To learn more about marketplace plans visit www.healthcare.gov/glossary/marketplace-plans/.
What are "marketplace plans"?
Marketplace plans are health insurance plans that meet certain requirements of the Affordable Care Act. They're also called individual health insurance plans because they can be sold to individuals and families who aren't covered through an employer or government program such as Medicare.
Marketplace plans may be sold by private companies or through government-run health insurance exchanges (also called marketplaces), which is where you'll find ACA 2019 marketplace plan prices on our site.
How can I find a marketplace plan?
You can use the Health Insurance Marketplace website to find out if you qualify for financial help.
When you’re on the health insurance marketplace website, click “I want to:” and then choose “See plans I can afford.” You will see a list of plans that includes information about each one, such as how much it costs and what services it covers. You will also be able to see other people's reviews of the plan from places like healthcare.gov or Kiplinger's Personal Finance magazine (link). If you have questions about a specific plan or want more information about your options, call 1-800-318-2596 (TTY: 1-855-889-4325) between 8 am – 9 pm ET Monday through Friday.
Can I keep my doctor?
Yes, you can keep your doctor.
You can also pick a new doctor.
You will have to make an appointment with your doctor and pay for the visit.
Doctors don't get paid until you pay them (if you don't have coverage). So if you don't have coverage, doctors may not see you as frequently as they would if they knew they'd be paid eventually. If you do have coverage, then your insurance company will bill the physician directly after providing services to their patient (you).
Can I get help paying for my marketplace plan?
If you enroll in a marketplace plan, you may qualify for a tax credit to help pay for your health insurance. If your income is between 100% and 400% of the federal poverty level, you may qualify for a premium tax credit that can reduce how much you pay each month for coverage. You also may qualify for cost sharing reductions if your income is between 100% and 250% of the federal poverty level.
Premium tax credits are available only if you purchase a silver-tier gold or platinum plan through the marketplace during open enrollment period (every fall). Cost-sharing reduction subsidies aren't available on bronze plans; they're only offered on silver-, gold-, or platinum-level plans purchased during open enrollment periods (every fall). If you buy any other type of plan outside of open enrollment periods -- including bronze-, silver-, gold-, or platinum-level plans -- then neither premium tax credits nor cost sharing reductions will be available to help offset their costs.
Do marketplace plans cover pre-existing conditions?
It's true that Marketplace plans can cover pre-existing conditions. The Affordable Care Act (ACA) requires most health insurance plans to cover you and your dependents regardless of any preexisting conditions, as long as you have continuous coverage.
When it comes to the Marketplace plans, there are different rules depending on your income and family size. For example, if your family earns less than 250% of the federal poverty level (FPL), which is $30,150 for a single person, both you and your dependents can get coverage with no limits on how much they'll pay out-of-pocket each year. In this case, all Marketplace plans must provide some cost-sharing reductions that help lower out-of-pocket costs for people who qualify for them based on their income level
Can Marketplace plans be used outside of the state I live in?
You can use a Marketplace plan anywhere in the United States. Most plans are available to residents of all states, but some plans are only available to people who live in certain states. You can find out if your state has a Marketplace plan by visiting healthcare.gov or contacting your state's department of insurance for more information on marketplace plans.
If you don't have a Marketplace plan that covers you outside your home state, there may be another type of insurance available to you in the state where you want to use it: private health insurance or an alternative called short-term coverage (STC). You can apply online at healthcare.gov or contact your state's department of insurance for more information on these other types of coverage policies and apply for them over the phone or through the mail if they accept applications this way instead of online.
How do I shop for a marketplace plan?
To shop for a Marketplace health plan, you can:
search for plans that work for you.
ask your doctor or nurse for advice about which plans offer the best coverage. Find someone who knows what your needs are and will be able to give you a list of companies offering plans in your area. You may also want to talk with people who already have marketplace coverage because they'll be able to give good advice based on their own experiences. This includes family members, friends, neighbors and coworkers who get insurance through the marketplaces or other sources like Medicaid/CHIP (Children's Health Insurance Program) or Medicare Advantage Plans;
ask an insurance agent if he or she has experience helping people sign up for Marketplace health insurance plans; A financial adviser could also help you find out whether there are better options than what's available on Healthcare Insurance Marketplaces;
call 1-800-318-2596 if you're looking into getting more information about how much certain policies cost without any tax credits or subsidies; If there are no subsidies available through Healthcare Insurance Marketplaces then these costs will apply only after meeting all requirements required before price comparisons could be made against individual state market prices which tend toward lower levels than national averages due largely due higher premiums elsewhere across America but still within affordability range provided by government subsidies offered via Affordable Care Act provisions such as Medicaid expansion (Medicaid+) program);
What are the benefits of marketplace plans?
Marketplace health insurance plans are available to you based on your income and household size. These plans offer a variety of benefits, including:
Coverage for pre-existing conditions
Access to coverage with no waiting periods or exclusions
More affordable options than other plans
Marketplace plans provide health insurance coverage to people who may not otherwise have health insurance coverage.
Marketplace plans are available to people who don't have health insurance. Marketplace plans are also available to self-employed individuals, small business owners, unemployed individuals and their families (the unemployed), Medicaid recipients and veterans. These plans provide consumers with more choice in their health care coverage.
Consumers can use marketplace plans to buy prescription drugs, medical equipment and other health care services.
Health Care Reform Subsidies are available when you purchase a marketplace plan through healthcare.gov or your state's website where they offer coverage in all 50 states including Washington DC today!
Conclusion
While marketplace plans provide many benefits, they may not be right for everyone. If you are thinking about getting a marketplace plan and need help deciding what's best for your family, please contact us today!
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